Provider Demographics
NPI:1679386627
Name:VITARELLI, ASHLYNN (DNP, APRN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:ASHLYNN
Middle Name:
Last Name:VITARELLI
Suffix:
Gender:F
Credentials:DNP, APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7840 NW 54TH CT
Mailing Address - Street 2:
Mailing Address - City:LAUDERHILL
Mailing Address - State:FL
Mailing Address - Zip Code:33351-5057
Mailing Address - Country:US
Mailing Address - Phone:727-504-8264
Mailing Address - Fax:
Practice Address - Street 1:5220 S UNIVERSITY DR STE 110C
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33328-5318
Practice Address - Country:US
Practice Address - Phone:727-504-8264
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-31
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11037446363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health